Rate of rebound in follicle growth after cessation of ovarian stimulation in initial non‐responders: a prospective cohort study

AbstractPreviously anecdotally observed rebounds in follicle growth after interruption of exogenous gonadotropins in absolute non-responders were the impetus for here reported study. In a prospective cohort study, we investigated 49 consecutive patients, absolutely unresponsive to maximal exogenous gonadotropin stimulation, for a so-called rebound response to ovarian stimulation. A rebound response was defined as follicle growth following complete withdrawal of exogenous gonadotropin stimulation after complete failure to respond to maximal gonadotropin stimulation over up to 5–7 days. Median age of study patients was 40.5 ± 5.1 years (range 23–52). Women with and without rebound did not differ significantly (40.0 ± 6.0 vs. 41.0 ± 7.0 years, P = 0.41), with 24 (49.0%) recording a rebound and 25 (51.0%) not. Among the former, 21 (87.5%) reached retrieval of 1–3 oocytes and 15 (30.6%) reached embryo transfer. A successful rebound in almost half of prior non-responders was an unsuspected response rate, as was retrieval of 1–3 oocytes in over half of rebounding patients. Attempting rebounds may, thus, represent another incremental step in very poor prognosis patients before giving up on utilization of autologous oocytes. Here presented findings support further investigations into the underlying physiology leading to such an unexpectedly high rebound rate.

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A PROSPECTIVE COHORT STUDY TO DEVELOP A TREATMENT ALGORITHM FOR CONTROLLED OVARIAN STIMULATION TO SELECT A STARTING DOSE OF RECOMBINANT FOLLICLE STIMULATING HORMONE BASED ON PATIENT CHARACTERISTICS AND OVARIAN RESPONSE (FAME STUDY)

Fertility and Sterility ◽

10.1016/j.fertnstert.2021.07.538 ◽

2021 ◽

Vol 116 (3) ◽

pp. e196

Author(s):

Chang-Woo Choo ◽

Ji Hyang Kim

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Ovarian Stimulation ◽

Prospective Cohort ◽

Follicle Stimulating Hormone ◽

Treatment Algorithm ◽

Ovarian Response ◽

Patient Characteristics ◽

Controlled Ovarian Stimulation ◽

Starting Dose

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Abstract P5-15-02: Safety of letrozole-gonadotropin controlled ovarian stimulation protocol in women with breast cancer undergoing fertility preservation before or after tumor resection via embryo or oocyte cryopreservation: A prospective cohort study

10.1158/1538-7445.sabcs14-p5-15-02 ◽

2015 ◽

Cited By ~ 3

Author(s):

Kutluk Oktay ◽

Jayeon Kim ◽

Giuliano Bedoschi ◽

Volkan Turan

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Fertility Preservation ◽

Prospective Cohort Study ◽

Ovarian Stimulation ◽

Prospective Cohort ◽

Tumor Resection ◽

Controlled Ovarian Stimulation ◽

Oocyte Cryopreservation ◽

Stimulation Protocol

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The Effect of Ovarian Stimulation on Endothelial Function—A Prospective Cohort Study using Peripheral Artery Tonometry

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa681 ◽

2020 ◽

Vol 105 (12) ◽

pp. e4722-e4729

Author(s):

Michal Kirshenbaum ◽

Jigal Haas ◽

Ravit Nahum ◽

Adva Aizer ◽

Yoav Yinon ◽

...

Keyword(s):

Cohort Study ◽

Endothelial Function ◽

Prospective Cohort Study ◽

Ovarian Stimulation ◽

Prospective Cohort ◽

Medical Center ◽

Reactive Hyperemia ◽

Peripheral Arterial Tonometry ◽

Follicular Maturation ◽

Arterial Tonometry

Abstract Context Gonadotropin-releasing hormone agonist (GnRH-a) serves as an alternative to human chorionic gonadotropin (hCG) to trigger final oocyte maturation, while it significantly reduces the risk of ovarian hyperstimulation syndrome (OHSS), probably by attenuating vascular/endothelial activation. Objectives The objectives of this work are to compare the effect of different modes of final follicular maturation (hCG vs GnRH-a) following ovarian stimulation (OS) for in vitro fertilization (IVF) on endothelial function. Design and Setting A prospective cohort study was conducted at a tertiary medical center. Participants Patients age 37 years or younger, undergoing OS for IVF, were allocated into 2 groups according to the type of final follicle maturation: the hCG group (n = 7) or the GnRH-a group (n = 8). Intervention Endothelial function was assessed by measurement of the peripheral arterial tonometry in reaction to temporary ischemia at 3 study points: day 3 of menstrual cycle (day 0), day of hCG/GnRH-a administration (day trigger) and day of oocyte pick-up (day OPU). The ratio of arterial tonometry readings before and after ischemia is called the reactive hyperemia index (RHI). Decreased RHI (< 1.67) indicates endothelial dysfunction. Main Outcome Measures The main outcomes measures of this study included endothelial function at 3 study points during OS with different modes of triggering final follicular maturation. Results The mean RHI values at day 0 were within the normal range for all patients and comparable between both groups (hCG: 1.7 ± 0.3 vs GnRH-a: 1.79 ± 0.4, P = .6). All patients presented a decrease in RHI values on day trigger, which did not differ between the 2 groups (1.62 ± 0.3 vs 1.4 ± 0.2, respectively, P = .2). However, the hCG group demonstrated a further decrease in RHI on day OPU, whereas patients who received GnRH-a had restored normal endothelial function reflected by increased RHI values (1.4 ± 0.2 vs 1.75 ± 0.2, respectively, P = .03). Conclusions Triggering final follicular maturation with GnRH-a restored normal endothelial function, whereas hCG trigger resulted in a decrease in endothelial function.

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